Antimicrobial resistance of isolated Streptococcus pneumoniae in a hospital of the Brazilian public system

Streptococcus pneumoniae is the predominant bacterial agent that affects the human population with pneumonia. This disease is an important cause of death in the elderly and the children under five years old. In this study, 29 strains of invasive S. pneumoniae were isolated from 29 patients of pneumonia, bacteremia and meningitis in the laboratory of the Municipal Hospital in Paulinia, Brazil, from May 2006 to October 2007. Patients' age ranged from 8 months old to 60 years old. These strains of S. pneumoniae were isolated from blood, pleural fluid and cerebrospinal fluid (CSF) of patients. After typing of encapsulated strains of S. pneumoniae through quellung reaction, their resistance to antimicrobial agents was gauged through Disc Diffusion Technique followed by determination of minimum inhibitory concentration (MIC). Among the 29 strains analyzed, 23 were methicillin-sensitive and six were methicillin-resistant and penicillin intermediate resistant. No strain presented full resistance to penicillin. Serotyping was performed only in two samples, which belonged to serotype 18. Our data may alert ambulatory regarding the incidence of pneumococcal strains resistant to the most common drugs due to inappropriate use of antimicrobials and also collaborate to the elaboration of pneumococcal conjugate vaccines specific to each region.

Complicated pneumonias with empyema and/or pneumatocele in children

To investigate the incidence, procedure type, characteristics of pleural fluid and pneumatoceles, and evolution of pneumonia complicated with empyema and/or pneumatoceles. Review of 394 pediatric pneumonia in patients at S (a) over capo Paulo State University Hospital during 2 years. We studied those with complications such as pleural effusion and pneumatocele. There were 121 (30.71%) with complications such as pleural effusion and pneumatocele; these were significantly higher in infants. One hundred and six children were needle aspirated, of these 78 underwent drainage, and 15 observation only. From the drained, seven needed thoracotomy or pleurostomy. Fluid was purulent in 50%, and pneumatoceles were seen in 33 cases (8.3%) with spontaneous involution in 28 (85%). Pleural fluid culture was negative in 51% cases; in positive cultures, Streptococcus pneumoniae was the most common agent. Complicated pneumonia incidence was higher in the second year of life and more than 70% occurred before 4 years of age. Closed thoracic drainage was effective in over 90%. Large effusions and mediastinal deviations were submitted to more aggressive procedures. Pneumatoceles predominated in the under 3s and were generally evident in the first chest X-ray. Most cases had spontaneous pneumatocele involution, and in almost half the cases were still present at drain tube removal.

Esparfloxacino e as fluorquinolonas: Uma revisao de sua classificacao, atividade antibacteriana, mecanismo de acao, caracteristicas farmacocineticas, tolerabilidade e perspectivas farmaceuticas

A revision was accomplished in the literature on the quinolones, antibacterial class that presents wide action spectrum, focusing, mainly, the sparfloxacin, third generation fluorquinolone which has potente activity against Gram positive organisms, including Streptococcus pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA), Gram negative organisms, Legionelia spp, Mycoplasma spp, Chlamydia spp and Mycobacterium spp, including multidrug resistant organisms.

Analise citotoxica de esparfloxacino e seus produtos de degradaçao em células mononucleares humanas

Sparfloxacin, a difluorquinolone derivative, is a potent antibacterial agent active against a wide range of gram-positive and gram-negative organisms including Streptococcus pneumoniae, Staphylococcus aureus, methicillin resistant S. aureus, Legionella spp, Mycoplasma spp; Chlamydia spp. and Mycobacteria. A drawback of fluorquinolones is their photoreactivity. Sparfloxacin has been studied in terms of therapeutic activities. However, few reports about analytical methods of sparfloxacin are available in the literature. The aim of this study was to determine cytotoxic effects, using sparfloxacin reference substance (SPAX-SR), sparfloxacin tablets (SPAX-COMP) and sparfloxacin tablets submitted UV light during 36 hours (SPAX-COMP.36) solution, and two isolated products (7 and 9) of SPAX-SR submitted UV-C light, in concentrations of 31.25, 62.5, 125 and 250 μg/mL by in vitro mononuclear humane culture cells. The results, statistically analyzed by Teste de Tukey, showed SPAX, SPAX-COMP and SPAX-COMP.36 solutions could reduce the cells number in these conditions. These results could not be observed for products 7 or 9. These results can suggest that isolated product can be less cytotoxic than SPAX-SR, is method can also be used to identified products degradation of sparfloxacin in stability study. However, the low activity achieved with sparfloxacin submitted to UV-light is a source of concern and requires further investigation about its photodegradation mechanism.

Análise térmica de esparfloxacino

Sparfloxacin, a third-generation fluoroquinolone, is a potent antibacterial agent against a wide range of Gram-positive and Gram-negative organisms, for example Streptococcus pneumonias, Staphylococcus aureus (including methicillin-resistant strains), Legionella spp., Mycoplasma spp., Chlamydia spp. and Mycobacterium spp. This compound has been submitted to thermal analysis and the results are presented here. The DSC curve of sparfloxacin has an endothermic peak that indicates a melting point at 276.5 °C. The DTA curve of the sample in synthetic air shows two exothermic peaks, at 341.6 and 579.2 °C, attributed to compound decomposition. In the TG curve, the loss of mass can be seen to occur in two steps between 285.5 and 645.3 °C. The DTA curve obtained in a nitrogen atmosphere shows an exothermic peak, with decomposition of sparfloxacin at 340.0 °C; from the corresponding TG plot, the loss of mass starts at 254.4 °C.

Pneumonias

Pneumonia is an infectious disease with great morbidity and mortality worldwide. According to the current guidelines recommendations the authors reviewed the treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). In this paper will be presented data about etiology, clinics and diagnostic tools. © Copyright Moreira Jr. Editora.

Impacto da eferocitose na fagocitose e atividade microbicida via recptores Scavenger em macrófagos alveolares papel de prostaglandina E2

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Fatores determinantes no resultado do tratamento do empiema pleural em crianças: drenagem pleural simples ou videotoracoscopia? Ensaio clínico controlado

Pós-graduação em Bases Gerais da Cirurgia - FMB

Meningitis and pneumococcal pyomyositis in a child with intramuscular hemangiomas: an autopsy case report

Pyomyositis is the bacterial infection of skeletal muscle, usually accompanied by abscesses. The main etiologic agent is Staphylococcus aureus. There are rare cases attributed to Streptococcus pneumoniae. This paper presents an autopsy of a four year old child with multiple congenital intramuscular hemangiomas that developed pneumococcal pyomyositis associated with meningitis. The authors propose the hypothesis that patients with hemangiomas, mainly the intramuscular type, may also represent a risk group for pyomyositis. The possibility of respiratory/meningeal co-infection, might also be considered even if the clinical picture is restricted to the muscular system.

Impacto da eferocitose na atividade microbicida via receptores “scavenger” em macrófagos alveolares: papel de prostaglandina E2

Segundo a Organização Mundial da Saúde, em países de baixa renda as infecções do trato respiratório ocupam o primeiro lugar dentre as causas de morte, sendo responsável por 11,2% das mesmas. Dentre estas, a causada por Streptococcus pneumoniae é uma das responsáveis pelo maior número de mortes em crianças ou adultos acometidos por doenças pulmonares crônicas. No pulmão os macrófagos alveolares (MAs) através de receptores expressos na superfície celular, como receptores “scavenger”, possuem um papel crítico na fagocitose e atividade microbicida de diferentes bactérias Gram-positivas. Em indivíduos acometidos por doenças pulmonares crônicas há um grande acúmulo de células apoptóticas (ACs) e estes podem ser mais susceptíveis a infecções pulmonares bacterianas como por S. pneumoniae. A presença destas ACs poderia contribuir para o aumento desta susceptibilidade através da supressão da resposta imune. Portanto, neste trabalho avaliamos se o efeito supressor mediado por ACs pode interferir na modulação das atividades microbicidas de MAs contra S. pneumoniae via receptores “scavenger”. A partir dos resultados encontrados, pode-se sugerir que 1) a eferocitose por MAs possui efeito imunossupressor na atividade microbicida contra S. pneumoniae; 2) a atividade supressora mediada pela fagocitose de ACs por MAs foi inibida na presença de bloqueadores de SR-A, sugerindo que os SR-B I/II são menos sensíveis a efeito supressor decorrente da eferocitose; 3) a PGE2, oriunda da eferocitose, liga-se ao receptor EP2 e suprime a atividade microbicida de MAs; 4) as produções de IL-1α, TNF-α e NO estão aumentadas na presença de ACs, sugerindo que a eferocitose por MAs promove um descontrole na ativação de MAs mediante a infecção por S. pneumoniae

Eferocitose na presença de PAMP estimula ativação de macrófagos de perfil misto M1/M2

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Multirresistência microbiana e opções terapêuticas disponíveis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito do extrato da folha de Psidium cattleianum na expressão protéica de Streptococcus mutans, no biofilme bacteriano e na desmineralização do esmalte

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Interação Candida albicans COM Acinetobacter baumannii E Klebsiella pneumoniae em biofilmes multiespécies

Pós-graduação em Biopatologia Bucal - ICT